Food & Health February 3, 2006 February 3, 2006 Chuck Treser - - PDF document

SLIDE 1

Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 1

ENVIR 202: Lesson 13 1

ENVIR 202: Lesson No. 13

Food & Health

Chuck Treser Chuck Treser

University of Washington University of Washington Program on the Environment Program on the Environment

February 3, 2006 February 3, 2006

ENVIR 202: Lesson 13 2

Overview

Food Quantity Problems Food Requirements Food Quality Problems

Foodborne Disease

ENVIR 202: Lesson 13 3

Food Properties

Food should be . . .

Safe Attractive Abundant Nutritious

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 2

ENVIR 202: Lesson 13 4

Food Quantity

Production:

World-wide, most suitable land is already under cultivation Yield per acre – increasing, but at slower rate Yield per unit of energy consumed in production – fishing, livestock are very costly in energy, produce high energy density but low quantity; food webs differ markedly in this respect. Effects of over-harvesting: exceed rate of reproduction Effects of habitat destruction

ENVIR 202: Lesson 13 5

Food Quantity

Storage:

Spoilage (oxidation, microbial decay): salting, smoking, refrigeration, chemical antioxidants (preservatives), irradiation Damage by vermin: rodents, arthropods Other mechanisms: dehydration

ENVIR 202: Lesson 13 6

Food Quantity

Distribution:

Transportation – dependent on local

• rganization and infrastructure

Cost to consumer – poverty, influence

• f intermediate participants

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 3

ENVIR 202: Lesson 13 7

Food Requirements

Metabolic (Energy) Demand:

Depends on age, gender, body surface

area, physical activity

Common units for:

measuring energy: joules, ergs, kilowatt-

hours, foot-pounds, British Thermal Units, kilocalories;

for measuring rate of energy consumption:

watts, horsepower]

ENVIR 202: Lesson 13 8

Basal (Resting) Metabolic Rate

34.5 37.2 50-54 35.3 38.3 40-44 36.9 41.0 20-24 51.6 53.0 5 Female Male Age

Body Surface Area(m2) = 0.202 x BW(kg)0.425 x H(m)0.725

Kcal/(m2-hr)

ENVIR 202: Lesson 13 9

Examples

Example 1:

21 year old female, 5’6” tall, 61 kg (134 lbs.) Body surface area = 1.667 m2 Resting metabolic rate = 1476 Kcal/day

Example 2:

57 year old male, 6’ 1.5” tall, 82 kg (180 lbs.) Body surface area = 2.067 m2 Resting metabolic rate = 1845 Kcal/day

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 4

ENVIR 202: Lesson 13 10

Effect of Exercise

600 Running 350 Swimming 250 Bicycling 140 Walking at 3 mile/hour 85 Standing 50 Sitting 35 Sleeping Energy Rate*

(Kcal/m2-hr)

Activity

*20 year old male

ENVIR 202: Lesson 13 11

Calories in Food

7

Ethanol

4

Protein

9

Fat

4

Carbohydrate Kcal/g

Component

Note: 1 metabolic Kcal = 1 dietary Calorie

ENVIR 202: Lesson 13 12

Example

For a diet including 36%

• f total

calories as fat:

500 g of food components (1.10 lb)

provides 2500 Kcal.

The balance between intake of food

and energy consumption determines storage and weight stability.

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 5

ENVIR 202: Lesson 13 13

Body Mass Index (BMI)

BMI (kg/m2) = weight (kg) / height (m2)

Underweight: BMI <20 Overweight: BMI >25 Obese: BMI >30 Health risks for those overweight:

diabetes heart disease

ENVIR 202: Lesson 13 14

Food Quantity

Conditions resulting from deficiencies:

Protein (8 essential amino acids) – kwashiorkor Total calories - marasmus Iron – anemia Iodide – goiter Vitamin A – blindness Vitamins B – beri-beri, pellagra Vitamin C – scurvy Vitamin D – ricketts Other essential trace components:

cobalt, zinc, magnesium, selenium, folic acid

Energy Density in Foods:

Energy density = total calories/g food Includes effects of bone, water, non-

digestible components such as fiber

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 6

ENVIR 202: Lesson 13 16

Food Energy Density

Low energy density foods: Contain relatively large amounts of air (popcorn, ice cream), water (soft drinks, fresh fruits and vegetables), or fiber (fruits and vegetables) High energy density foods: Contain relatively large amounts of fat (animal meats), and are heavily processed to remove air, water, fiber (TV dinners, Powerbars). These properties have important considerations for world-wide nutrition and health.

ENVIR 202: Lesson 13 17

Food Properties

However, food is

susceptible to:

Spoilage Contamination Adulteration

which can render it unfit

to eat

• E. coli Bacterium

ENVIR 202: Lesson 13 18

Food Quality

Deliberate Additives

(regulated by Food and Drug Administration and the US Dept. of Agriculture, based on risk assessment) Preservatives - eg, benzoic acid, sorbic acid, propionic acid Flavorings - natural, artificial Texture Modifiers - eg, gums, emulsifiers Genetically Modified Organisms (GM0) - pest resistance, flavor

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 7

ENVIR 202: Lesson 13 19

Food Quality

Unintentional Contaminants

(FDA, USDA, US Environmental Protection Agency, State and Local Health Departments)

Pesticides, fertilizers, pollutants in soil and water Antibiotics and other animal feed additives

ENVIR 202: Lesson 13 20

Unintentional Contaminants

Microbiological contaminants - from

animals, water, human food handlers (preparation, serving)

Infectious agents - food borne infection E.g., salmonella, campylobacter, E. coli Microbial toxins - food borne intoxication E.g., botulism, staphyloccal enterotoxin, bacillus cereus toxin, aflatoxin

ENVIR 202: Lesson 13 21

Foodborne Disease

There are two

types of foodborne illness

Infections Intoxications

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 8

ENVIR 202: Lesson 13 22

Foodborne Disease Continued

Infections are caused by:

The presence of micro-

• rganisms in large numbers

which multiply in the gut and

• verwhelm the body’s

defenses

ENVIR 202: Lesson 13 23

Foodborne Infections

Amebic Dysentery Brucellosis Campylobacter enteritis Diarrhea(Acute) Viral gastroenteritis

ENVIR 202: Lesson 13 24

Foodborne Infections Continued

Salmonellosis Shigellosis Trichinosis Typhoid Fever Infectious Hepatitis

Mallon as she was portrayed in an illustration in the June 20, 1909, edition of The New York American

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 9

ENVIR 202: Lesson 13 25

Foodborne Disease Continued

Intoxications are caused by

chemicals or “toxins”

Produced by micro-organisms,

• r by

Contamination with natural or

manufactured chemicals

ENVIR 202: Lesson 13 26

Foodborne Intoxications

Botulism Staphylococcal food poisoning Clostridium perfrigens Bacillus cereus

ENVIR 202: Lesson 13 27

Foodborne Toxins Continued

Scromroid fish poisoning (Histamine) Ciguatera fish poisoning Paralytic shellfish poisoning (PSP) Amnesic shellfish poisoning (domoic acid) Puffer fish poisoning (tetrodotoxin)

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 10

ENVIR 202: Lesson 13 28

Types of Pathogens

Sporeforming Bacteria

Clostridium botulinum Clostridium perfringens Bacillus cereus

Non-sporeforming Bacteria

Salmonella spp. Campylobacter

• E. coli O157:H7

Staphylococcus aureus Listeria monocytogenes

Viruses

Hepatitis A Norwalk Virus

ENVIR 202: Lesson 13 29

Normal Symptoms

• f Foodborne Disease

Nausea Vomiting Diarrhea Cramps Headache Fever Chills Body Aches

ENVIR 202: Lesson 13 30

Complications

• f Foodborne Illnesses

Kidney Damage Blood Poisoning Pneumonia Arthritis

(2% will trigger)

HUS

(5-20K cases/ yr)

Guillian Barre

Syndrome

Chronic

Sporadic Toxoplasmosis

Neurological

Damage

Pancreatic

Infections

Chronic Illness -

likely to occur in 2-3%

• f FBIs

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 11

ENVIR 202: Lesson 13 31

High Risk Individuals

Infants Children Pregnant Women Senior Citizens People taking medications:

Antibiotics Antacids Immuno-suppressive drugs

Immuno-compromised people:

Recent major surgery Pre-existing or chronic illness HIV / AIDS Diabetes Cancer Liver or Kidney Damage Ulcers

ENVIR 202: Lesson 13 32

Contributing Factors

Factors Contributing to an increased

risk of Foodborne Illness

Aging Populations Lifestyles of the Public New and Emerging Pathogens Increase in High Risk Individuals New Processing Methods for Foods New Sources of Foods - Geographic

ENVIR 202: Lesson 13 33

24% 2% 5% 1% 68% Bacterial Viral Chemical Parasitic Unknown

Bacteria 24% Viral 68% Chemical 5%

Foodborne Disease Outbreaks

United States, 1993-1997

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 12

ENVIR 202: Lesson 13 34

50% 5% 1% 3% 41% Bacterial Viral Chemical Parasitic Unknown

Bacteria 50% Viral 41% Parasitic Chemical Unknown

Foodborne Disease Cases

United States, 1993 - 1997

ENVIR 202: Lesson 13 35

Foodborne Disease

Reported Incidence

Believed to be only the tip of the iceberg 1%

• r less are even

reported 76 million cases annually

Image courtesy of Douglas Armand Digital Imaging Used with permission ENVIR 202: Lesson 13 36

100 200 300 400 500 600 700 800 900 Home Food Service School Picnic Church Camp Other Unknown Bacterial Viral Chemical Parasitic Unknown

Foodborne Disease Outbreaks

United States, 1993-1997

Home Food School Picnic Church Camp Other Unknown Service

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 13

ENVIR 202: Lesson 13 37

Deaths from Food

United States, 1988 - 1992

2 4 6 8 10 12 14 16 18 20 Number 1988 1989 1990 1991 1992 Y e a r Unknown Viral Parasitic Chemical Bacterial

1988 1989 1990 1991 1992 ENVIR 202: Lesson 13 38

Distribution of Outbreaks

United States, 1995

129 ENVIR 202: Lesson 13 39

Foodborne Illness in Washington

Estimated Annual Number of Food-

borne Illnesses in Washington State

(extrapolated from CDC U.S. estimates - 2000)

1.5 million illnesses 6500 hospitalizations 100 deaths

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 14

ENVIR 202: Lesson 13 40

32 47 51 126 145 134 112 104 59 91 66

68

20 40 60 80 100 120 140 160

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

YEAR NUMBER

Foodborne Outbreaks 1990-2001

ENVIR 202: Lesson 13 41

31.1% 23.7% 20.3% 19.7% 18.0% 12.8% 12.8% 12.7% 11.5%11.5%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% Percentage of Outbreaks w/ Factor

Inadequate Handwashing (C-15) Inadequate Hot Holding (P-6) Inadequate Refrigeration (P-3) Slow Cooling (P-2) Cross Contamination (C-9) Bare Hand Contact (C-10) Ill or Infected Person (C-12) Room Temperature Storage (P-1) Inadequate Cleaning of Equipment (C-13) Prior Preparation (P-4)

Contributing Factors N=695

Major Factors Associated with FBDO's WA State 1990-1999

ENVIR 202: Lesson 13 42

7.20% 6.60% 5.90% 2.20% 1.70% 1.00% 0.90% 0.70%

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% Percentage or Outbreaks w/ Factor C

• n

t a m i n a t e d R a w I n g r e d i e n t ( C

• 7

) I n a d e q u a t e C

• k

i n g ( S

• 1

) I n a d e q u a t e R e h e a t i n g ( S

• 2

) P

• l

e d E g g s ( C

• 1

7 ) C

• n

t a m i n a t e d I n g r e d i e n t ( C

• 6

) N a t u r a l T

• x

i c a n t ( C

• 1

) T

• x

i n A c c i d e n t a l l y A d d e d ( C

• 3

) I m p r

• p

e r T h a w i n g ( S

• 4

) E x c e s s Q u a n t i t y T

• x

i c C h e m i c a l ( C

• 4

) I n s e c t / R

• d

e n t C

• n

t a m i n a t i

• n

( C

• 1

8 ) P r

• l
• n

g e d C

• l

d S t

• r

a g e ( P

• 5

) Contributing Factors N=695

Minor Factors Associated with FBDO's WA State 1990-1999

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 15

ENVIR 202: Lesson 13 43

Foodborne Disease Outbreaks by Place, 1990 -1999, Washington State

Restaurant 46% Caterer 14% Prison/Jail 8% Camp 5% Food Store 4% Home 4% Food Processor 3% School 3% Health Care Facility 3% Other 10%

Other includes places that were under 3%. In decreasing order they are: Growers, Temporary Food Service Establishment, Private Club, Community or Confernece center, Homeless Shelter/Mission, Church, College/University, MobileFSE, Fair, Coffee Stand, Private Dinner and Picnic. ENVIR 202: Lesson 13 44

Significant Food Ingredients for FBDO's WA State 1990-1999

19.60% 13.40% 12.10% 11.50% 10.80% 7.70% 4.70% 3.80% 3.20% 3.20% 2.50% 2.20% 0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 14.00% 16.00% 18.00% 20.00% Poultry Introduced By Worker Starchy Foods Beef Other Vehicle Shellfish Finfish Pork Eggs Other Seafood Green Leafy Vegetables Dairy

Significant Ingredient

The following significant ingredients were excluded from this graph because they were less than 2%. (Beverages, Fruits, Other, and Other Vegetables)

N = 530*

*376 FBDO's were excluded from the data before analysis. ENVIR 202: Lesson 13 45

CASES of ILLNESS

Signifi ficant Food Ingredients Foodborne Disease Outbreaks WA State 1990-1999

26.00% 22.20% 14.30% 11.80% 4.80% 3.00% 3.00% 2.00%

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00%

Introduced by Worker Beef Poultry Starchy Foods Other Vehicle Shellfish Finfish Pork

N= 6807*

* From 530 outbreaks with significant ingredients Others (< 2% of cases): Eggs, Other Seafood, Green Leafy Vegetables, Dairy, Beverages, Fruits, Other, Other Vegetables)

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 16

ENVIR 202: Lesson 13 46

Trends

• In the 80’ s…
• Was beef …

… … … … … … ...

• Was turkey …

… … … … … ..

• Was roast beef and

turkey ...

• Some viruses …

… … … … … .

• Was Salmonella…

… … … … .

• Some Mex/Chinese…

… … …

• Was cooling…

… … … … … ..

• E. coli

emerged… … … … … . ..

• No Fruit/Veg
• utbreaks…

..

• In the 90’ s…
• Now hamburger
• Now chicken
• Now RTE foods & Starchy

foods

• Now nearly 1/2 the cases

are viral

• Still Salmonella
• Increased M/Ch + others
• Now handwashing
• O157:H7, Crypto, ETEC,
• Lots of F/V –

sprouts, juice, melons, green leafys, etc…

ENVIR 202: Lesson 13 47

Disease Causation Factors

Food Handling Practices:

Poor Handwashing Cross Contamination Improper Heating Improper Cooling

ENVIR 202: Lesson 13 48

Disease Causation Factors

Continued

Diversity in the Food Industry

Changes in eating habits More types of foods (ethnic, seasonal) Greater shelf life (transportation) More foods are imported New food products are coming out New food processes

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Lesson 13: Food & Health February 3, 2006 ENVIR 202: Population & Health 17

ENVIR 202: Lesson 13 49

Questions

ENVIR 202: Lesson 13 50

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